Robotic hysterectomy in Trendelenburg position in a severely anaemic JKa alloimmunised patient with impending high-output cardiac failure: An anaesthetic challenge
| Autor: | Ajay Kumar Bhargava, Shagun Bhatia Shah, Rajiv Chawla, Amardeep Pathak |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Blood transfusion
hyperbilirubinemia business.industry Kidd blood group system Previous pregnancy medicine.medical_treatment Trendelenburg position Anaemia autoimmune Haemolysis haemolytic lcsh:RD78.3-87.3 Robotic hysterectomy Anesthesiology and Pain Medicine lcsh:Anesthesiology Anesthesia Delayed haemolytic transfusion reaction robotic surgical procedures Medicine Indirect Antiglobulin Test business Severe anaemia |
| Zdroj: | Indian Journal of Anaesthesia, Vol 62, Iss 5, Pp 385-388 (2018) |
| ISSN: | 0019-5049 |
| Popis: | Kidd blood group alloimmunisation, though extremely rare, may produce considerable morbidity, and even mortality. Severe anaemia and impending high-output cardiac failure requiring blood transfusion should be weighed against the risk of severe transfusion reactions even with fully cross-matched blood. Kidd antibodies are a common cause of delayed haemolytic transfusion reaction (DHTR) since they have a tendency remain undetectable in plasma. A low -grade DHTR (second hit) was grossly amplified by a second DHTR (third hit) superimposed on it in our patient leading to severe haemolysis with serum bilirubin reaching 68 mg%. Indirect antiglobulin test (indirect Coombs reaction) should ideally be performed in all patients (scheduled for major surgery requiring blood transfusion) who have experienced a previous pregnancy or blood transfusion. Non-invasive continuous haemoglobin monitoring and non-invasive cardiac output monitoring can prove invaluable tools in management. |
| Databáze: | OpenAIRE |
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